Differential diagnosis of physical signs in the posterior segment
 
Introduction
2)  Inflammatory 3)  Macular changes
 
Subretinal, sub-RPE and choroidal haemorrhages
(Figure on the left shows the presence of all three haemorrhages
in a patient with traumatic choroidal rupture)

All these haemorrhages have the same differential diagnosis and 
they often co-exist. In the case of subretinal haemorrhage, the 
haemorrhage is bright red and large with indistinct outline. In 
sub-RPE haemorrhage, the blood appears dark-red and have 
well-defined outline. In choroidal haemorrhage, the blood is 
also dark-red but unlike sub-RPE haemorrhage, it is often extensive.

 
 

Roth's spots:


 

Hard exudates:


 

Cotton wool spots
 


 
 

Neovascularization


 

Retinal vasculitis:
 


 
 

Retinal emboli:


 

Arterial attenuation:


 

Venous dilatation and tortuosity:

macular oedema (caused either by: 1. breakdown of the blood retina barrier
                                                     or   2. breakdown of the retinal pigment epithelium barrier)
  white dot syndromes
      without inflammation
      • retinitis punctata albescens
      • fundus albipunctus
      • fundus flavimaculatus
      • Doyne honeycomb dystrophy
      • malattia levantinese
      • beign retinal syndrome
      • Alport's disease
      • Vitamin A deficiency

      with inflammation

      • multiple evanescent white syndrome
      • acute posterior multifocal placoid pigment epitheliopathy
      • punctate inner choroidopathy
      • birdshot chorioretinopathy
      • diffuse unilateral subacute neuroretinits
      • acute retinal pigment epithelitis
      • serpiginous choroiditis

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Panuveitis atrophic maculopathies bull's eye maculopathies choroidal neovascularization
 

epiretinal membranes


macular holes


 
 

crystalline maculopathies

cherry red spots isolated pigmented lesion isolated pale lesion
 

diffuse pigmented lesion


 
 

Diffused white fundus

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Choroidal folds

Angioid streaks
  Retinal detachments Choroidal detachments